Explaining Substance Use among Puerto Rican Older Adults: Impact of Perceived Discrimination, Perceived Stress, and Social Activities.

Background: Despite Puerto Ricans having one of the highest rates of substance use among Hispanic groups in the United States, limited research has focused on the impact of perceived discrimination and stress on substance use among older adults. Individuals who experience stressful events are inclined to engage in harmful behaviors as a coping mechanism. Objectives: Based on the propositions of the General Strain Theory, the current study explores the relationship between perceived discrimination, perceived stress, social activities, and the use of alcohol and cigarettes. Methods: Baseline data from the Boston Puerto Rican Health Study collected in 2014 was used to conduct a logistic regression analysis. Results: The findings reveal that while perceived discrimination is significantly linked to both types of substance use, social activities may serve as a protective factor for cigarette use. Conclusion/Importance: Our study findings emphasize the need to examine perceived discrimination as a stressor impacting the health and well-being of Puerto Ricans in later adulthood. Policy implications for reducing substance use and directions for future research are discussed.

Self-Reported Vision Loss, Health Status, and Social Participation Among Middle-Aged and Older Adults-Evidence From China.

Social participation is crucial for enhancing senior's well-being and promoting their integration into society. Using nationwide data investigated in China, this study explored the association between self-reported visual impairment, health level, and social participation among Chinese middle-aged old adults. It has been found that (a) the probability and frequency of social participation among middle-aged and older adults with self-reported vision loss were significantly lower than those without vision problems; (b) self-reported vision loss was negatively associated with self-rated health and mental health status, and both were positively associated with social participation; and (c) self-rated health and mental health played a mediating role between vision loss and social participation. The findings suggest that under the framework of active aging, universal vision screening programs and rehabilitation plans for the older adults with visual impairment are exceedingly significant to promote their participation in social activities, thereby enhancing their quality of life.

Effects of Changes in Frequency of Going Out during the COVID-19 Pandemic on ikigai (Sense of Purpose in Life) and Mental Health in Middle-Aged and Older Adults in Japan.

To clarify whether changes in frequency of going out due to the COVID-19 pandemic affect ikigai (sense of purpose in life) and mental health in Japanese middle-aged and older adults. In a questionnaire survey mailed to 16,866 adults aged > 40 years in Japan in September 2020, 7,973 responses were received (response rate, 47.3%) in October 2020. Following exclusions, data from 6,978 individuals (50.6% female, mean age 67.8 ± 12.2 years) were available for analysis. Respondents were categorized based on changes in frequency of going out, reflecting changes in social and/or physical activity, during the pandemic compared with before it: the previously active group went out often before but less often during the pandemic; the remained active group continued going out often; and the inactive group continued not going out often. Whether these changes affected the respondents' ikigai and mental health was investigated. The previously active group had a significantly higher proportion of individuals with decreased ikigai during the pandemic than the other groups. Mental health score decreased in all groups during the pandemic, but more so in the previously active group (-3.21), followed by the inactive and then the remained active groups (-1.45 and -1.28, respectively). Previously active individuals showed the greatest decline in ikigai and mental health among the three groups. These findings suggest that continuing to engage in appropriate physical and social activities, including going out, while following appropriate infection control measures, even under restrictions, can help people maintain ikigai and mental health.

Risk Factors of Progression to Cognitive Frailty: Singapore Longitudinal Ageing Study 2.

INTRODUCTION: Cognitive frailty is associated with higher risk of dementia and adverse health outcomes. However, multidimensional factors that influence cognitive frailty transitions are not known. We aimed to investigate risk factors of incident cognitive frailty. METHODS: Prospective cohort study participants were community-dwelling adults without dementia and other degenerative disorders and baseline and follow-up, including N = 1,054 participants aged ≥55 free of cognitive frailty at baseline, with complete baseline (March 6, 2009, to June 11, 2013) and follow-up data at 3-5 years later (January 16, 2013, to August 24, 2018). Incident cognitive frailty was defined by one or more criteria of the physical frailty phenotype and <26 of Mini-Mental State Examination (MMSE) score. Potential risk factors assessed at baseline included demographic, socioeconomic, medical, psychological and social factors, and biochemical markers. Data were analyzed using least absolute shrinkage selection operator (LASSO) multivariable logistic regression models. RESULTS: A total of 51 (4.8%) participants, including 21 (3.5%) of the cognitively normal and physically robust participants, 20 (4.7%) of the prefrail/frail only, and 10 (45.4%) of cognitively impaired only, transited to cognitive frailty at follow-up. Risk factors for transition to cognitive frailty were having eye problem (OR = 2.6, 95% CI 1.24-5.43) and low HDL cholesterol (OR = 4.1, 95% CI 2.03-8.40), while protective factors for cognitive frailty transition were higher levels of education (OR = 0.3, 95% CI 0.10-0.74) and participation in cognitive stimulating activities (OR = 0.4, 95% CI 0.17-0.82). CONCLUSION: Multi-domain modifiable factors especially related to leisure activities predict cognitive frailty transition and may be targeted for prevention of dementia and associated adverse health outcomes.

Social participation in the city: exploring the moderating effect of walkability on the associations between active mobility, neighborhood perceptions, and social activities in urban adults.

BACKGROUND: Living in urban environments is associated with several health risks (e.g., noise, and air pollution). However, there are also beneficial aspects such as various opportunities for social activities, which might increase levels of social participation and (physically) active mobility that in turn have positive effects on health and well-being. However, how aspects of the environment, active mobility, and social participation are associated is not well established. This study investigates the moderating effect of low vs. high walkability neighborhoods on the associations between active mobility, and social participation and integrates individuals' subjective perception of the neighborhood environment they are living in. METHODS: Cross-sectional data from 219 adults (48% female, mean age = 46 ± 3.8 years) from 12 urban neighborhoods (six low, six high walkability) were analyzed: First, social participation, active mobility, and subjective neighborhood perceptions were compared between people living in a low vs. high walkability neighborhood via t-tests. Second, multigroup path analyses were computed to explore potential differences in the associations between these variables in low vs. high walkability neighborhoods. RESULTS: Social participation, active mobility, and subjective neighborhood perceptions didn't differ in low vs. high walkability neighborhoods (p: 0.37 - 0.71). Active mobility and subjective neighborhood perceptions were significantly stronger related to social participation in low vs. high walkability neighborhoods (active mobility in low: ß = 0.35, p < .01 vs. high: ß = 0.09, p = .36; subjective neighborhood perceptions in low: ß = 0.27, p < .01 vs. high: ß = 0.15, p = .18). CONCLUSIONS: Despite living in neighborhoods with objectively different walkability, participants rated social participation and active mobility equally and perceived their neighborhoods similarly. However, zooming into the interrelations of these variables reveals that social participation of residents from low walkability neighborhoods depends stronger on active mobility and perceiving the environment positively. Positive perceptions of the environment and active mobility might buffer the objectively worse walkability. Future research should focus on underlying mechanisms and determinants of subjective neighborhood perceptions and active mobility, especially in low walkability neighborhoods.

The association of spousal depressive symptoms and cognitive function among older adults: mediation and moderated mediation analyses.

OBJECTIVES: To test whether contagious depressive symptoms mediate the association between spousal depressive symptoms (spousal-DS) and the other spouse's cognitive function, and test the moderated mediation of social activities engagement and sleep quality. STUDY DESIGN: A total of 3,230 adults aged ≥60 and one of his/her close relatives were interviewed in 2016 in Xiamen, China. METHODS: Cognitive function and depressive symptoms were measured by MoCA and GDS-15/CES-D-10, respectively. Social activities engagement and sleep quality were self-reported. Mediation and moderated mediation were tested by PROCESS macro with 5000 bootstrapping re-samples. RESULT: Among all, 1,193 pairs were husband-wife with complete information and were included. The mean ages of older adults and their spouses were 68.35 ± 6.53 and 66.53 ± 7.91 years, respectively. The mean MoCA and GDS-15 scores for older adults were 22.21 ± 5.45 and 1.73 ± 2.17, respectively. The average score of CES-D-10 for spouses was 14.18 ± 4.77. Spousal-DS were associated with cognitive functions of older adults via the contagious depressive symptoms (indirect effect: -0.048, 95% confidence interval (CI): (-0.075, -0.028)). Such mediation can be buffered by attending social activities (interaction: -0.062, 95% CI: (-0.111, -0.013)) and improving sleep quality (interaction: -0.034, 95% CI: (-0.057, -0.012)). CONCLUSION: Cognitive function of older adults was associated with his/her spouse's depressive symptoms, and the association was mediated by contagious depressive symptoms and moderated by social activities as well as sleep quality.

Inequalities in associations between young adult caregiving and social relationships: Evidence from the UK Household Longitudinal Study.

INTRODUCTION: Young adult caregivers (aged 16-29 years) are an important but underrecognized group of informal caregivers. There is some evidence suggesting that young adult caregivers have fewer social relationships. However, this research has been largely cross-sectional in design or restricted to caregivers, providing no comparison with noncaregivers. Further, there is little evidence on whether and to what extent there are inequalities in associations between young adult caregiving and social relationships by gender, age, caregiving intensity, or household income. METHODS: Using five waves of data on 3-4000 young adults aged 16-29 from the UK Household Longitudinal Study, we investigated associations between becoming a young adult caregiver and subsequent social relationships (number of close friends and participation in organized social activities) in the short-term (1-2 years after caregiving initiation) and longer-term (4-5 years later). We also assessed differences by gender, age, household income, and caregiving intensity. RESULTS: Overall, those who became young adult caregivers, and particularly those providing 5+ h/week, reported fewer friends in the short- but not longer-term. No associations were observed between young adult caregiving and participation in organized social activities. Also, there was no evidence of differences by gender, age, income, or caregiving hours. CONCLUSIONS: Becoming a young adult caregiver is associated with a reduction in number of close friends, particularly in the short-term. Given the importance of practical and emotional support provided by friends, the early identification of young adult caregivers and greater population awareness of caring in young adulthood may help to mitigate the effects on social relationships.

The Role of Physical Vulnerability in the Association Between Social Activities and Cognitive Performance in Rural Older Adults: A Longitudinal Study.

The aim of this study was to examine the association of social activities with cognitive performance in older adults in the southern area of Brazil, considering the important moderating role of physical vulnerability. A prospective population-based study was conducted in the rural area of Rio Grande, Rio Grande do Sul, Brazil. Self-reported social activities were collected at baseline. Cognitive performance and physical vulnerability were measured in the second wave of data collection. The association of social activities with cognitive performance was determined using robust generalized linear models. In adjusted analysis, the social activities were positively associated with cognitive performance in physically vulnerable older adults. However, this association was not found in those who were nonvulnerable. Our findings may contribute to future investigations of possible explanatory avenues for the association between social activities and cognitive performance as well as the development of interventions aimed at improving cognitive skills.

Addressing Loneliness in Older People Through a Personalized Support and Community Response Program.

Loneliness is increasingly viewed from a public health perspective given its association with poor physical and mental health. This includes tackling loneliness as an element of policy to promote mental health and wellbeing recovery post Covid. Facilitating participation of older people in social activities is part of the cross-governmental strategy to address loneliness in England. Such interventions have more chance of being effective if they resonate with and sustain engagement with their intended target audience. This study explored experiences of a personalized support and community response service to loneliness in Worcestershire, England. It involved interviews with 41 participants, gaining insights on routes into the program, perceived impacts, suitability and appeal. Results indicate multiple entry pathways, reaching individuals who would otherwise never have initiated engagement. Many participants felt the program promoted their confidence and self-esteem, as well as reengagement in social activities. Volunteers were pivotal to positive experiences. The program did not have universal appeal; some would have preferred a befriending service, whilst others desired opportunities to engage in intergenerational activities. Early identification and better understanding of determinants of loneliness, as well as co-creation, flexibility in form, regular feedback and volunteer support would help strengthen program appeal.

Effects of providing free hearing aids on multiple health outcomes among middle-aged and older adults with hearing loss in rural China: a randomized controlled trial.

BACKGROUND: Hearing loss has been associated with serious health problems around the globe. Previous studies have found the positive effects of fitting hearing aids on health, but few studies were conducted in developing countries. The aim of this study is to examine the effects of hearing aids on multiple health outcomes among middle-aged and older adults with hearing loss in rural China. METHODS: In this randomized controlled trial (RCT), participants aged 45 and above were randomly assigned to the treatment group prescribing with hearing aids or to the control group with no intervention. Trial outcomes for 385 participants were collected during the 20-month follow-up study. Using the difference-in-difference approach, our primary outcomes were hearing-related quality of life (QoL) and generic QoL. RESULTS: The intervention led to improvements in hearing-related QoL, presenting as the reduction in Hearing Handicap Inventory for the Elderly Screening Version (HHIE-S) scores (interaction coefficient = - 2.86, p = 0.005), HHIE-S-Emotional scores (interaction coefficient = - 1.42, p = 0.029), and HHIE-S-Situational scores (interaction coefficient = - 1.43, p = 0.007). The intervention was also effective in alleviating the increase in depressive symptoms (interaction coefficient = - 0.14, p = 0.042). Subgroup analysis revealed that the effects were only shown among people with social activities or active social networks. CONCLUSIONS: Our study is the first RCT in China to measure the health effects and heterogeneity of hearing aid interventions. Wearing hearing aids can help improve hearing-related QoL and alleviate the increase in depressive symptoms. The intervention is expected to be applicable to similar settings in other developing countries to combat hearing-related health problems. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR1900024739 . Registered on 26 July 2019.

Scoping study of definitions of social participation: update and co-construction of an interdisciplinary consensual definition.

BACKGROUND: considering the importance of social participation for quality of life and active ageing in older adults, it is an important target of social and health professionals' interventions. A previous review of definitions of social participation in older adults included articles up to 2009; new publications and changes in the social context (e.g. social media and the COVID-19 pandemic) justify continuing this work. OBJECTIVE: this paper provides an updated inventory and synthesis of definitions of social participation in older adults. Based on a critical review by content experts and knowledge users, a consensual definition is proposed. METHODS: using a scoping study framework, four databases (MEDLINE, CINAHL, AgeLine, PsycInfo) were searched with relevant keywords. Fifty-four new definitions were identified. Using content analysis, definitions were deconstructed as a function of who, how, what, where, with whom, when, and why dimensions. RESULTS: social participation definitions mostly focused on people's involvement in activities providing interactions with others in society or the community. According to this new synthesis and input from content experts and knowledge users, social participation can be defined as a person's involvement in activities providing interactions with others in community life and in important shared spaces, evolving according to available time and resources, and based on the societal context and what individuals want and is meaningful to them. CONCLUSION: a single definition may facilitate the study of active ageing and the contribution of older adults to society, socioeconomic and personal development, benefits for older adults and society, self-actualisation and goal attainment.

The association between social activity and physical frailty among community-dwelling older adults in Japan.

BACKGROUND: Physical frailty is associated with social activity. However, the relationship between physical frailty and levels of engagement with other people during social activities remains unclear. Thus, we aimed to clarify the relationship between physical frailty and social activity using a taxonomy of activity levels among community-dwelling older adults in Japan. METHODS: This cross-sectional observational study analyzed data from 12,788 older adults (7001 women, mean age: 73.8 years, standard deviation = 5.9; range: 60-96 years) from the National Center for Geriatrics and Gerontology-Study of Geriatric Syndromes. Physical frailty was assessed using the following components: slow walking speed, muscle weakness, exhaustion, low activity, and weight loss. We asked participants about seven social activities that included social participation and engagement and examined their relationship to physical frailty. RESULTS: Physical frailty was independently associated with all social activities. Exercise circle activity, which includes a level of social participation, was strongly associated with physical pre-frailty and physical frailty. Results of sub-analyses indicated that the level of social engagement was independently associated with physical frailty in the older group (over 75 years) but not in the younger group (60-74 years). CONCLUSIONS: Our results indicate that the strength of the association between social activity and physical frailty differs by the level of social participation. Given the increasingly high prevalence of physical frailty in Japan and its strong association with numerous adverse health outcomes, the relationship between physical frailty and levels of social participation may assist in developing measures to prevent the incidence and progression of physical frailty.

[Non-participation in social activities of rural older adults: Results from the Toyama dementia survey].

Objective　Social activities play an important role in the maintenance of health and well-being of the older adults. The aim of this study was to identify characteristics of the rural older adults who do not participate by type of social activities.Methods　This survey examined 1,537 older adults randomly selected at a sampling rate of 0.5% from among those living in Toyama prefecture of Japan, in 2014. Of the total, 947 ambulatory older adults living in their own homes were analyzed using Poisson regression. Results were presented as prevalence ratio (PR). The level of statistical significance was set at P<0.05 (two-sided test).Results　The participants included 426 men (mean age 73.9 ± 6.5 years) and 521 women (mean age 74.8 ± 7.0 years).　In terms of work, both men and women did not work at an older age (men PR 1.15 over 75 years old, women PR 1.11 over 70 years old). Men did not work during outpatient treatment (PR 1.09) and the Revised Hasegawa Dementia Scale (HDS-R) 21-25 points (PR 1.09) and 20 points or below. Women who did not drink alcohol did not work (PR 0.93).　Both men and women did not participate in residential activities at older ages (men PR 1.12 over 70 years old, women PR 1.11 over 80 years old). Men with 20 points or below on HDS-R (PR 1.16) and with work history of only physical labor (PR 1.12), and women living with family (PR 0.92) were less likely to participate in residential activities.　In the hobby group, both men and women with work history of only physical labor were less likely to participate (men PR 1.05, women PR 1.08). Men with education of 9 years or below (PR 1.05) and women living alone (PR 1.07) were less likely to participate. Hobby groups did not relate with age and cognitive decline.　In the senior citizens' club, men and women who did not drink alcohol were less likely to participate (men PR 0.91, women PR 0.89). Men who smoked (PR 1.06), men with psychological symptoms (PR 1.09), and women with 20 points or below on HDS-R (PR 1.13) were less likely to participate.Conclusion　Factors related to non-participation of older adults in rural cities depended on the type of social activities. In order to promote social activity among the older adults in rural cities, it is important to consider specific measures taking into account the type of social activities.

Association of living arrangements with happiness attributes among older adults.

BACKGROUND: In Korea, along with the rapid aging of the population, older adults' living arrangements have changed in various ways. In particularly, the happiness of older adults living alone warrants attention because they are more vulnerable to unhappiness than those living with families are. This study reports on the level of happiness among older adults in Korean and examines the potential mediating roles of depressive symptoms, present health status, socio-physical environment, social support networks, and social activities, and happiness in three different living arrangements, older adults living alone, with their spouse, or with their family. METHOD: Data for this study were extracted from the secondary data from the 2017 Korean Community Health Survey, a non-experimental, cross-sectional survey conducted among Korean individuals that were aged 65 and above (n = 14,687). The chi-square test, one-way ANOVA, and Logistic regression were used to explore the related factors of happiness among the three groups. RESULTS: Findings revealed a significant difference in the happiness index among older adults living alone (6.22 ± 2.11), older adults living with their spouse (6.76 ± 1.99), and older adults living with their family (6.46 ± 1.94) (F = 88.69, p < .001). As the result of logistic regression, older adults living alone (odds ratio (OR) = 0.75, 95% confidence interval (CI) = 0.57-0.99) and those living with their family (OR = 0.80, 95% CI = 0.65-0.99) demonstrated greater happiness as the frequency of contact with their family increased. Older adults living with their spouse indicated an increase in happiness when their contact with friends was higher (OR = 0.69, 95% CI = 0.56-0.84). CONCLUSION: It was recognized that factors influencing happiness differed according to older adults' living arrangements, thus suggesting that older adults' happiness could be facilitated through interventions that consider their circumstances, including living arrangements.

Supplementary grandchild care, social integration, and depressive symptoms: longitudinal findings from Korea.

OBJECTIVES: Despite growing concerns about the heavy reliance on supplementary grandchild care in Korea, understanding of its longitudinal effects on the grandparents' mental health has been limited. This study examined whether transition patterns of grandchild care among Korean grandparents were associated with changes in the grandparents' depressive symptoms, directly or indirectly, through changes in two domains of social integration (intergenerational contact and social activities) after controlling for socioeconomic characteristics and baseline levels of depressive symptoms and social integration. METHOD: Using the Korean Longitudinal Study of Aging (N = 4,362), a nationally representative multiwave survey, we examined four possible statuses of grandchild care over a three-year period: started (n = 64), continuous (n = 73), and discontinued (n = 103) caregiving, and non-caregiving (n = 4,121). The proposed mediation model was analyzed using structural equation modeling with non-caregivers as a reference group, and Wald tests were conducted to further examine differences in the effects across the three caregiving groups. RESULTS: The direct effects of grandchild care on depressive symptoms in Korean grandparents were not significant. Rather, those who started or continuously provided caregiving had significantly reduced depressive symptoms via increased intergenerational contact compared to the non-caregiving group. CONCLUSION: These findings indicated beneficial effects of grandchild care on depressive symptoms in Korean grandparents through increased social integration within the family. Implications of the study findings were discussed.

Pro-Social and Altruistic Behaviors of Military Students in Random Events.

The cognitive purpose of the research presented in the article is to identify the propensity for pro-social and altruistic behavior among first-year military students (of basic training) in three simulated situations of need for help to other people. It raised the question contained in the main research problem: to what extent do military students at universities tend to behave in a pro-social and altruistic way in situations that pose a threat to the other people's life and health, and what is the relationship between these behaviors and socialization in the civil environment? At the outset, the hypothesis was adopted that the candidates for professional soldiers show (or at least should show) a higher propensity for this type of behavior. For its verification, the population of the first-year military students during their basic training was assumed as a research area. The study covered 246 people (85 women and 161 men) selected randomly from among military students in the first year of studies of the command profile (major in management and command studies) of all military specialties and the medical profile. The selection of the research sample based on first-year students during the basic training (1 month of service) aimed to identify the impact of environmental factors (primary and secondary socialization as a "civilian") on the tendency to altruistic and pro-social behavior in two different groups of candidates for professional soldiers.

The association between health-related factors, physical and mental diseases, social activities, and cognitive function in elderly Koreans: a population-based cross-sectional study.

AIM: The purpose of this study was to verify the association of cognitive function with health-related variables, diseases, and social activities. METHODS: Data from the 2016 Korean Longitudinal Study of Aging were analyzed. The participants of that study were 5678 adults aged 60 years or older living in 17 major Korean regions nationwide. RESULTS: Hierarchical multiple regression analyses indicated that gender, age, education, marital status, depressive symptoms, body mass index, regular exercise, activities of daily living, instrumental activities of daily living, hand grip strength, and social activities were all significantly associated with cognitive function in elderly Koreans. However, socioeconomic status, diabetes, smoking, alcohol consumption, attendance at school reunions, volunteer work, and participation in political or civic organizations had no impact on cognitive function. First, the results indicated that men had better cognitive function than women; likewise, married individuals and those with a higher level of education also had better cognitive function. As age increased, cognitive function declined. Second, higher body mass index was related to poorer cognitive function, whereas regular exercise was positively associated with better cognitive function. In addition, higher activities of daily living and instrumental activities of daily living scores were associated with poorer cognitive function. Third, depressive symptoms were negatively associated with cognitive function. Finally, religious activities, social activities, and participation in leisure activities, cultural events, and sports were associated with better cognitive functioning. The possibility of reverse association exists between some of the variables (e.g. religious activity and cognitive function), and it is necessary to verify this possibility through a longitudinal study. The biggest limitation is that this is a cross-sectional study, which made it unfeasible to investigate the causal pathways. CONCLUSIONS: This study suggests that regularly exercising and attending social activities each help to improve cognitive function in the elderly.

The Relationship between Subjective Cognitive Impairment and Activity Participation: A Systematic Review.

This systematic review synthesizes current evidence to determine how subjective cognitive impairment (SCI) relates to physical, cognitive, and social activity participation in older adults. Nine peer-reviewed articles were reviewed and appraised for evidence quality. Most were cross-sectional and had high methodological quality. Higher levels of SCI were almost universally associated with lower levels of physical and social activity participation. These findings suggest that older adults who report higher SCI engage in fewer activities. Examining these relationships longitudinally is an important next step to determine whether SCI precedes withdrawing from activities in older adults.

Participation in Community Group Activities Among Older Adults: Is Diversity of Group Membership Associated With Better Self-rated Health?

BACKGROUND: Participation in community activities (eg, sports and hobby groups or volunteer organizations) is believed to be associated with better health status in the older population. We sought to (1) determine whether a greater diversity of group membership is associated with better self-rated health and (2) identify the key dimension of the membership diversity (eg, gender, residential area, or age). METHODS: We performed a cross-sectional study of 129,740 participants aged 65 years and older who were enrolled in the Japan Gerontological Evaluation Study in 2013. We assessed the diversity of group membership using (1) a continuous variable (range 0-4) accounting for the total degree of each diversity dimension or (2) dummy variables for each dimension. We estimated prevalence ratios (PRs) and 95% confidence intervals (CIs) for better self-rated health according to the diversity of group membership, using Poisson regression and robust variance with multiple imputation, adjusted for other covariates. RESULTS: The participants involved in social groups with greater diversity had better self-rated health: the PR per one point unit increase in diversity was 1.03 (95% CI, 1.02-1.04). Participation in gender-diverse groups was associated with the best profile of health (PR 1.07; 95% CI, 1.04-1.09). CONCLUSIONS: Among the older population in Japan, higher group diversity is associated with better self-rated health. Gender is the key dimension of diversity that is associated with better self-rated health.

A latent class analysis of social activities and health among community-dwelling older adults in Korea.

OBJECTIVES: This study presents an empirical typology of social activity and its association with the depressive symptoms and self-rated health of community-dwelling older adults (n = 464) in South Korea. METHOD: Latent class analysis (LCA) was used to classify the types of social activities. Data analyses were conducted using Mplus 7.2 program for LCA and SPSS 22.0 for multiple regression analyses. RESULTS: LCA identified people who fell into one of the four activity groups: Diverse, Community Center/Disengaged, Religion Plus, and Friendship/Leisure. Membership in these four groups predicted differences in depressive symptoms and self-rated health. CONCLUSIONS: Results indicate that typologies of social activity could enhance practitioners' understanding of activity patterns and their associations with health and well-being.